Elkattawy Sherif, Noori Muhammad Atif Masood, Sah Anuraag, Hasan Kazmi Syed M, Desai Dhaval
Internal Medicine, Rutgers New Jersey Medical School/Trinitas Regional Medical Center, Elizabeth, USA.
Internal Medicine, Dow Medical College, Karachi, PAK.
Cureus. 2020 Jul 24;12(7):e9371. doi: 10.7759/cureus.9371.
Lambl's excrescences (LEs) are thin filiform strands of connective tissue found on the closure line of valves. Their exact etiology is unknown, and most of them are typically asymptomatic. We present a case of a 33-year-old African American male with a history of right upper extremity weakness that resolved on its own within a few minutes. On physical examination, no focal neurologic deficit was observed. MRI brain showed a tiny curvilinear focus of restricted diffusion with subtle T2-FLAIR hyperintensity in the left frontal/insular region, indicating a recent cortical infarct. Transesophageal echocardiogram (TEE) was performed as a part of cryptogenic stroke workup, which showed LE on aortic valve leaflet tips. Our patient had elevated blood pressure (BP) on arrival; however, in LE's presence, the embolic phenomena of stroke cannot be excluded. In conclusion, this case adds to a limited number of cases with such cardioembolic phenomena, which will help in further illustrating and highlighting the need for more prospective studies to establish a causal relationship between LE and cardioembolic strokes.
兰布尔赘生物（LEs）是在瓣膜闭合线上发现的结缔组织细丝状条索。其确切病因尚不清楚，大多数情况下通常无症状。我们报告一例33岁非裔美国男性病例，该患者有右上肢无力病史，数分钟内自行缓解。体格检查未发现局灶性神经功能缺损。脑部MRI显示左侧额叶/岛叶区域有一个微小的曲线状扩散受限灶，T2-FLAIR呈轻微高信号，提示近期皮质梗死。作为隐源性卒中检查的一部分，进行了经食管超声心动图（TEE）检查，结果显示主动脉瓣叶尖有兰布尔赘生物。我们的患者入院时血压升高；然而，存在兰布尔赘生物时，不能排除卒中的栓塞现象。总之，该病例增加了此类心源性栓塞现象的有限病例数，这将有助于进一步说明和强调需要进行更多前瞻性研究，以建立兰布尔赘生物与心源性栓塞性卒中之间的因果关系。
